She was still a young woman. She told me that she was having pain on her side, that she was not feeling well, that she would struggle to pick up the baby that day. That she thought her side was red and painful and felt hot. I was due to go to the practice that morning and this young woman, who came in three days a week to care for the baby while I worked, my first born who was still only six months old, had just arrived. I asked her if she wanted to show me her side. She lifted her top to expose an angry bubbling rash, like a quick sweep of blotchy red paint, across the whole side of her chest. With that one glance I knew what this was, I feared what it heralded for her and dreaded the death sentence that it brought at a time when treatment was not yet available.
Ten years before that day I vividly remember sitting in a clinical lecture hall waiting for the lecturer during my third year of medicine discussing a very new, still unidentified, disease that was impacting many communities internationally and now increasingly being seen in our own country. Those very first whisperings of an unknown illness, spoken about with concern in every forum and corridors of the hospitals, made a lasting impact on my memory. That nascent unknown disease became a tsunami of suffering, illness and death, and came to occupy almost every bed in the hospital, almost to exclusion of all else. And with it came a companion wave of funerals, of orphans, of panic, desperation, fear and isolation, one that my family has felt intimately with the death of three housekeepers over the years. Kind, generous, and patient women who cared for my children while I gave time to others. Women whom my own children viewed as surrogate mothers and still deeply feel the loss of, and whom I wish to honour today.
Each year, since 1988, we have commemorated and celebrated World AIDS Day on the first of December. Remembering those who have succumbed to this disease and renewing our commitment to the continued work and caring to be done. This year is no different. Progress has been made. We now know the cause, the transmission routes, are able to protect against this and treat effectively when discovered early. UNICEF and ICPCN, like many other international organisations, commemorate World AIDS Day today with the following statement.
At the turn of the century, and the beginning of the Millennium Development Goals, and HIV diagnosis was equivalent to a death sentence for most children and their families in low income countries. But now, an early diagnosis paired with treatment and care can ensure long healthy lives, regardless of location, and helps prevent transmission of HIV to others.
Much progress has been made and while better treatment and prevention is making an impact there is still cause for concern, especially amongst adolescents, and especially for the age group from 15 to 19. In Africa AIDS is the number one cause of adolescent deaths and worldwide the number two cause. Seven of ten new infections are amongst girls. HIV prevention efforts have shown little impact for adolescent transmission rates over the past 15 years. We need to envisage new and creative ways to engage adolescents in this discussion while also challenging, acknowledging and attending to the power and gender struggles impacting this age group. With most new infections being amongst adolescent girls this speaks to on-going gender struggles, abuse and powerlessness of young women in patriarchal societies.
This World AIDS Day make a commitment to being a difference in your own lives, in your own families, in your own work and communities, in teaching and embodying for your own children and the young persons you have contact with to have mutual respect and honouring of their own and each other’s bodies and personal power, as well as safeguarding them from abusive relationships and situations. Silence has often been a killer with this disease. Don’t be afraid to speak out and speak up.